Dr. Ramchandra Lamba
Psychiatry
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Patient's Query
Hello doctor,
I am a 19-year-old college student. I have been diagnosed with depression two years ago and I have been taking Sertraline ever since. My mental health is a mess right now. I think I have restless leg syndrome and I always have the urge to move my feet and legs especially when I am lying down. Also, I have been dissociating, every once in a while, real life feels like a dream and I sometimes cannot recognize my own face in the mirror. But here is what really bothers me, the intrusive thought of death that cannot leave me at all. I close my eyes and see horrible images and think about death and visualize my loved ones dying.
I have also been having recurring nightmares, almost daily, really disturbing, and often death. I also tend to worry a lot about my loved ones and always feel the need to check up on them. It became like an obsession and I fear losing control and losing stuff. I have a lot of doubt about my spiritual and religious life. In total, I am really anxious and distressed. I now have heavy heartache feeling and I tend to clench my jaws and fists. I also suffer from a restless sleep. Please help.
Hi,
Welcome to icliniq.com.
I have gone through your concern and it seems that you have an obsession and your restless leg can be due to iron deficiency or it may be due to Sertraline. So check out your hemoglobin, and complete blood count to rule out iron deficiency anemia.
Restless leg can be managed by adding Pramipexole or Gabapentin tablet. You did not mention about the doses of Sertraline, if required its dose can be up or downed to manage depression.
Avoid coffee or tea. Maintain a diary of your symptoms. Do regular exercise. Take a healthy diet.
I hope this helps.
Patient's Query
Thank you doctor,
I take 50 mg Sertraline a day. Do you think I have OCD? That is one of my main concerns. Please reply.
Hello,
Welcome back to icliniq.com.
Yes, I think you have OCD (obsessive-compulsive depression). You can check your score on YBOCS (Yale brown obsessive compulsive scale) you can do this online and if the score is more than 8, then it is more likely due to OCD. However, to confirm the diagnosis you need to visit your psychiatrist in person.
The dose of Sertraline can be increased to 100 mg daily to mange your depression and obsessive symptoms. If restless leg symptoms increase then either add Pramipexole or reduce the dose of Sertraline and then change to other drugs like Fluoxetine or Fluvoxamine.
I hope this helps.
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Psychiatry
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